Is It Becoming Safer to Eat During Labor?

Summary: Doctors have long encouraged women in active labor to avoid solid foods, instead sipping on water or juice, snacking on a popsicle or crunching ice chips. Their reasoning: if you have to go under anesthesia for an unplanned C-section, having undigested food in your stomach can be dangerous. But, according to one new analysis, safer anesthesia techniques are decreasing these risks, making avoiding solids unnecessary. The data, if reaffirmed in future studies, could mean doctors will begin embracing solid foods in the labor and delivery ward — a welcome change for women with long labors who need an extra boost of energy.

In most hospitals, your menu options during labor are scant: popsicles, Gatorade and clear soup broth are standard fare. During a many-hours-long-labor this can mean a tired, hungry mom who's not able to effectively push her baby out, which could possibly even lead to interventions. The restrictions have long been in place for a reason: If you have to go under emergency anesthesia and have food in your stomach, you might aspirate (breathe into your lungs) small particles of food, a dangerous occurrence. But growing evidence suggests that the risk of this happening is so tiny — and getting more substantial food during labor is advantageous enough — that avoiding solids might be unnecessary. The latest data supporting this view was presented this weekend at the Anesthesiology 2015 annual meeting in San Diego.

"Pregnant women want to eat, they're hungry, and their lack of energy is palpable," says Stephanie Romero, an obstetrician at the University of South Florida who was not involved in the new study. "It would be at her hospital," she says, "women who have been induced for 24 hours and are still waiting for labor to progress are offered small meals, but clear liquid diets are enforced otherwise."

In 2009, the American College of Obstetrics and Gynecology (ACOG) relaxed their guidelines for food during labor, which had previously advised that women should only consume ice chips. The updated guidelines, still in effect today, stated that women may drink clear liquids including water, fruit juice without pulp, soda, black coffee or tea and sports drinks. They still recommend avoiding solid foods, however.

Now, researchers from Memorial University in Canada have looked at 385 separate studies on hospital births published since 1990, as well as databases of anesthesia complications. Between 2005 and 2013, they found, there was only one case of aspiration associated with childbirth among women who ate (some hospitals with midwife centers have more lax rules about it, say experts), in a woman with obesity — a risk factor for aspiration. They also found no cases of death associated with aspiration in the United Kingdom. The extremely low rate of complications, they hypothesize, is due to advances in anesthesia, including lower use of breathing tubes during procedures, which used to be more common and boosts the risk of food aspiration. Moreover, their review of the literature found a plethora of evidence supporting the idea that women who are able to eat have shorter labors and less emotional stress.

Due to the evidence, the researchers say, they would recommend that women who aren't obese, haven't been diagnosed with preeclampsia and aren't using opioid painkillers be allowed light meals — such as soup, fruit or toast — during labor.

What this means to you. Doctors are unlikely to immediately start allowing solid foods during labor, Romero thinks. "Just based on this review of the literature, I don't see anybody changing practice," she says. "But, it's a good starting point to do more research going forward." Select hospitals, for instance, could start allowing solid foods during labor for women without risk factors and report on whether it truly shortens labors or leads to fewer interventions, for instance.

For now, Romero recommends keeping an open dialogue with your healthcare practitioner about what their policy is regarding labor food. If you know their guidelines up front, it can mean you're more prepared during labor and don't have unrealistic expectations. Many doctors, for instance, recommend chowing down in the early stages of labor, before you check in to the labor and delivery ward, so that you aren't hungry right away.